What is ADHD?
No one knows exactly what causes ADHD, but it seems to run in families. Genetics and problems with the brain’s frontal lobe during development are probably involved.
To diagnose your child, a mental health provider will review notes and observations from teachers and caretakers, use rating scales, and rule out other disorders that cause similar symptoms.
Signs and Symptoms of ADHD
When you hear about ADHD, you may picture a hyperactive kid who talks nonstop and can’t sit still. But, as adults, you can also have symptoms of ADHD that make it hard for you to stay organized and focused at work or home. You might have trouble remembering appointments and underestimate how long tasks will take. You might also struggle with impulsive behavior, especially in stressful situations. Women are more likely to have these inattentive symptoms of ADHD than men, and they are more often misdiagnosed as having depression, anxiety, or mood disorders. Only trained healthcare providers can diagnose ADHD. They follow the guidelines in the American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition (DSM-5)1.
In order for someone to meet criteria for ADHD, they must show signs of attention deficit disorder that are noticeable and cause significant suffering. This means that he or she is having trouble sitting still, waiting their turn, paying attention, or being fidgety; having trouble finishing tasks or staying on task; being forgetful and failing to follow instructions; being easily bored and unable to concentrate; and/or being overly impulsive. However, it’s normal for kids to be distracted and restless from time to time. They also often have problems that look like ADHD because of learning disabilities, certain medical conditions, psychological disorders or major life events.
Types of ADHD
Many medical conditions, psychological disorders, and stressful life events can cause symptoms that look like ADHD. It is important to have a thorough assessment by an experienced healthcare professional, especially for children.
Inattentive ADHD (formerly called ADD) is the most common type of ADHD and is diagnosed in more girls and adults than boys. People with this type have difficulty sustaining attention and following instructions, and are easily distracted by extraneous stimuli. They also make careless mistakes that are often due to forgetfulness and poor planning and organizational skills. They have trouble keeping track of personal belongings and paperwork, and are frequently late for work or other commitments.
People with hyperactive-impulsive ADHD are restless and hard to calm down. They may talk nonstop, interrupt others, or blurt out answers without waiting to be asked. They have trouble with self-control and may get into fights or other dangerous situations. They tend to climb on things, crash into walls and furniture, or play like Tigger from the Winnie the Pooh series.
They are prone to losing their school supplies and keys, and may have trouble remembering what they have already done or said. Brain mapping tests reveal abnormal connectivity within and between the prefrontal cortex and basal ganglia, which is associated with ADHD hyperactivity and impulsivity.
Causes of ADHD
Many factors may play a role in ADHD. Genes are likely involved, as well as environmental and developmental issues. Some of these include low birth weight, pre-eclampsia, smoking and alcohol use during pregnancy, and exposure to certain toxins (such as lead and pesticides) at critical periods of brain development. Studies also show that there is a connection between the frontal lobes of the brain and attention deficit disorder, as well as between the caudate nucleus and impulsivity and hyperactivity.
People with ADHD often have trouble paying close attention and tend to make careless mistakes. They often daydream or seem distracted. They have trouble following instructions or staying focused in schoolwork, chores, work and other activities. They may have trouble getting along with others or keeping jobs and relationships.
People with ADHD can still be creative and imaginative. They can be brilliant inventors, master problem-solvers and wonderful artists. They can also have powerful emotions and be prone to anger or temper tantrums. Regardless of the type of ADHD, symptoms interfere with daily functioning in many ways and can cause significant suffering in children, adolescents and adults. Children and adults with these difficulties need help. They need routines and structure, healthy eating habits, good sleep, regular exercise, face-to-face support from family and friends and strategies for reducing stress.
How is ADHD Diagnosed?
Symptoms of ADHD can appear in many ways, making diagnosis challenging. A family doctor can screen for the condition and refer you to a professional for an evaluation.
To be diagnosed with ADHD, a person must exhibit at least six of nine symptoms and have difficulty functioning at home, school or work. Among the symptoms are trouble keeping track of tasks, failing to follow instructions, being easily distracted, getting bored or losing interest in activities quickly, forgetting important events and misplacing things like keys and wallets. The hyperactive-impulsive symptoms include fidgeting with hands or feet, frequently leaving their seat, being restless, having trouble playing or engaging in leisure activities quietly and often blurting out answers or interrupting others.
It’s important for doctors evaluating someone with ADHD to take a thorough history, including family and social history. A rushed visit can lead to mistakes. Certain medical problems, psychological disorders and major life events can also cause symptoms that look like ADHD. These conditions can include learning disabilities, sleep problems, thyroid problems, drug or alcohol use and stress. Mental health professionals can help parents and children cope with feelings of frustration, blame and anger that sometimes arise when a child receives an ADHD diagnosis.
Treatsments for ADHD
In addition to medications, psychotherapy can help children and adults manage their symptoms. Behavioral therapy usually involves teaching kids and adults new behaviors and rewarding good behavior. Psychoeducation, a form of counseling that educates people about ADHD, can also be helpful.
Many different conditions can cause problems that look like ADHD. These include learning disabilities, psychological disorders such as anxiety or depression and some medical conditions, including thyroid problems and certain seizures.
Most children with ADHD get better when treated with medication and behavioral therapy. But kids need help from their parents, teachers and other caregivers to keep up with school work, get enough sleep and avoid risky behaviors that can lead to trouble at home or at school.
Adults with ADHD often benefit from psychotherapy, particularly cognitive behavioral therapy that helps people change negative patterns of thinking that contribute to their symptoms. Marital or family therapy can also improve communication and problem-solving skills. Medications for adults with ADHD typically involve stimulants, such as products that contain methylphenidate or amphetamine. Nonstimulant medications, such as atomoxetine or some antidepressants, may also be used if stimulants don’t work or cause side effects. Symptoms of ADHD can also improve when individuals get exercise, eat healthy foods and get enough sleep.
ADHD in Adults
Although the symptoms of ADHD appear differently in adults, they typically affect multiple areas of life. This is why treatment is important.
Adults can experience problems at school, home, and work. They may find it difficult to prioritize tasks or follow through on commitments. They can also be restless, forgetful, and impulsive. They might easily get distracted, make careless mistakes, or lose their things. They might speak out before thinking, or have trouble waiting for their turn at games or conversations.
A diagnosis of ADHD requires that the symptoms have been present since before age 12. The disorder must interfere with social, academic, or professional functioning. Symptoms must be more severe than expected for a person’s age.
People with ADHD tend to have a greater risk of depression, anxiety disorders, eating disorders, substance abuse, and other mental health conditions. It is important to identify and treat ADHD early, as it can have many long-term negative effects, including psychological distress, low self-esteem, problems with relationships, family discord, academic failure, delinquency, accidental injuries, and job failure. There are many ways to help manage ADHD symptoms, from counseling and behavioral therapy to ADHD medications. Some people also benefit from lifestyle changes and support services.
Many people with ADHD benefit from taking prescription medications. The most common type of medication healthcare providers prescribe are stimulants. These medicines help children, teens, and adults focus their thoughts and ignore distractions. They’ve been used safely for decades. But some people experience side effects. These may include upset stomach, changes in blood pressure and heart rate, and tics (sudden, repetitive movements or sounds like eye blinking or throat clearing).
Stimulant medicine has helped 70% to 80% of people with ADHD get better. They work by increasing the levels of certain chemicals in the brain (neurotransmitters) that affect mood and behavior. These drugs are only effective if they’re taken as prescribed by a doctor. It takes time to find the right dose of a medicine that works for you or your child. You or your child should see a healthcare provider regularly until the dosage is right.
Some mental health conditions, such as anxiety or depression, can make ADHD symptoms worse. They can also cause other problems that look like ADHD, such as trouble with schoolwork or relationships. So it’s important to tell a healthcare provider about any mental health problems you or your child has.
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